Wednesday, December 3, 2008

Evening update (Wednesday, 12/3)

After a big day of evacuating his bowels, Max got to start eating again this afternoon at 5 pm. He has started again on breastmilk (not fortified with anything yet), every 3 hours. His stomach circumference now measures 29 cm, down from a high of 34 cm Tuesday morning. We hope that he will tolerate his feeds o.k. and get everything moved through his system, avoiding another big blowup/meltdown like yesterday.

A blood culture from this afternoon hasn't show anything problematic yet (unlike the culture drawn Tuesday morning: read more here). A further sepsis workup would have involved cultures from a urinalysis and an LP. But 3 different people poked Max's spine today and couldn't get any CSF out, and they couldn't get a urine sample via a Foley catheter either. So they are putting Max on antibiotics to address anything that might be brewing, and will continue to watch the blood cultures over the next 48 hours or so. Oh, and Max has developed some kind of rash/yeast infection in his groin area and they are treating that with a topical creme.

As of tonight, Max's head circumference remains stable at 34.5 cm - great!

Max's nurse reports that he was "sassy" during his bath tonight, which is a welcome change from his previous lethargy. This is also how he was behaving today during physical therapy (PT). It was good to see him alert and engaged.

I only got to hold Max for about an hour today - the rest of the time he was getting PT, or having LP attempts, or just sacked out and resting quietly from all this activity. I hung a page from Where the Wild Things Are on one of the IV carts by his isolette: the page with the character Max smiling in his boat marked with "Max." Nurse Becky commented that the book's character looked like our Max, except that he had more hair. (No word yet on the scheduled start of the Wild Rumpus.)

Max is getting a lot less respiratory support, and continues to have few/no As, Bs or Ds.